Key Takeaway:
- U.S. tetanus cases nearly doubled from 18 in 2023 to 33 in 2025, raising concerns among public health experts.
- Doctors link the increase largely to declining vaccination rates and growing vaccine hesitancy, including among some parents.
- Tetanus remains rare but potentially deadly; experts say vaccination is the safest and most effective prevention.
Tetanus cases in the United States increased from 18 in 2023 to 33 in 2025, according to a recent medical report, with health experts citing declining vaccination rates and urging renewed prevention efforts.
Doctors warn against growing vaccine hesitancy
Tetanus, a serious bacterial infection caused by Clostridium tetani, is drawing renewed concern from public health officials after a recent increase in reported U.S. cases. As tetanus cases rise across the country, experts say the trend is significant because the disease is almost entirely preventable through vaccination.
A recent viewpoint article published in the Journal of the American Medical Association reported that cases rose from 18 in 2023 to 33 in 2025, the latest year for which data is available. The findings come as tetanus cases rise in the United States, raising concerns among public health experts about declining vaccination rates.
“Tetanus is very painful and, if it’s not rapidly treated, it can be deadly,” said Dr. Jon Andrus, a professor of global health at George Washington University’s Milken Institute School of Public Health.
The Centers for Disease Control and Prevention reports that tetanus cases have declined by more than 95% since 1947, when the vaccine became a routine part of childhood immunization schedules. Health officials say even a modest increase warrants attention because the disease remains potentially fatal.
Unvaccinated children account for several cases
Medical experts point to vaccine hesitancy as a key factor behind the recent rise in infections as tetanus cases rise in the United States.
“We’re seeing that there is more of a pushback against the tetanus vaccine,” said Dr. Kathryn Edwards, lead author of the JAMA report and a professor of pediatrics at Vanderbilt University Medical Center.
According to Edwards, the CDC (Centers for disease control and prevention) recently documented four tetanus cases in unvaccinated children whose parents declined vaccination after emergency room visits for injuries. The children later developed the disease.
Tetanus bacteria are commonly found in soil, manure, and environmental surfaces. The infection occurs when bacterial spores enter the body through cuts, puncture wounds, or scrapes. Once inside, the bacteria can produce a toxin that attacks the nervous system.
“It is in the ground and will always be around,” Edwards said. “If you get an injury to your skin and the bacteria get inside, it can produce a toxin that makes you sick.”
Symptoms typically appear between three and 21 days after exposure and may include jaw muscle spasms, commonly known as lockjaw, difficulty swallowing, painful muscle stiffness, seizures, fever, and changes in blood pressure or heart rate.
Vaccination remains the best defense
Health experts stress that vaccination remains the most effective protection against tetanus.
“Vaccination is really key with this,” said Dr. John Sellick, an infectious disease specialist and professor of medicine at the University at Buffalo.
Doctors recommend following the routine vaccination schedule and receiving booster shots as advised. Emergency tetanus vaccination may also be recommended after certain injuries, depending on a patient’s vaccination history.
The disease can cause severe complications, including breathing difficulties, pneumonia, blood clots, and broken bones resulting from intense muscle spasms. CDC data indicate that about one in 10 tetanus cases in the United States is fatal.
Recovery can be lengthy. Many patients require intensive care and mechanical ventilation while the toxin’s effects gradually wear off.
Public health officials are raising concerns as tetanus cases rise and declining vaccination rates continue to fuel worries about preventable diseases.
“We have to vaccinate our children and ourselves against these old diseases, or they will come back,” Andrus said.
Health authorities continue to encourage vaccination as the most reliable way to prevent tetanus and avoid potentially life-threatening complications.
